<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Nạp thẻ điện thoại tự động</title>
</head>

<body>
<form method="post" action="process.php" id="form">
<table width="100%" border="0" cellpadding="3" cellspacing="3">
	<tr>
    	<td colspan="2" align="center">
        	<h2>Nạp thẻ điện thoại</h2>
        </td>
        
    </tr>
    <tr>
    	<td align="right" width="40%">
        	Nhà Mạng :
        </td>
        <td>
        	<select id="lstTelco" name="lstTelco">
            	<option value="1">Viettel</option>
                <option value="2">MobiFone</option>
                <option value="3">Vinaphone</option>
                <option value="4">Gate</option>
                <option value="5">Vcoin</option>
            </select>
        </td>
    </tr>
    <tr>
    	
    	<td align="right">
        	Số Seri :
        </td>
        <td>
        	<input type="text" id="txtSeri" name="txtSeri" />
        </td>
    </tr>
    <tr><td align="right">
        	Mã số :
        </td>
        <td>
        	<input type="text" id="txtCode" name="txtCode" />
        </td>
    </tr>
     <tr>
    	<td align="right">
        	
        </td>
        <td>
        	<input type="submit" value="Nạp thẻ" />
        </td>
    </tr>
</table>
</form>
</body>
</html>
